Self-Harm

Definition:

Self-Harm - Any form of deliberate, premeditated injury, such as cutting, poisoning or overdosing, inflicted on oneself.

The Wounding

Self-harm, self-injury, self-abuse or self-mutilation typically refer to behaviors which are not suicidal in nature, although attempts at self-harm occasionally result in death.

Reliable statistics about these behaviors are not easy to find, partly because self-harm has received relatively little attention from the scientific community and partly because a large proportion of self-harm events are believed to be performed in secret.

Self-harm is generally considered to be most common among adolescents and young adults, although there is little scientific data to back this up.

Self-harm does not have its own listing in either the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) or in the World Health Organization’s International Classification of Diseases (ICD-10), although there are some who believe it should. Self-harm is included as one of the nine possible DSM Criteria for Borderline Personality Disorder.

British Medical Journal 2002 Study on Self-Harm in Adolescents

A 2002 survey of 15 and 16 year old students in 41 schools in England found that 6.9% reported acts of deliberate self-harm in the previous year, with a significantly higher prevalence in females (11.2%) than in males (3.2%).

Incidents Reported Total respondents(%)

Deliberate self harm:39858016.9%

Male

9830783.2%

Female

299270311.2%

Gender Unspecified

1205.0%

Suicidal thoughts(no self harm):863573715.0%

Male

25830258.5%

Female

602269222.4%

Gender Unspecified

32015.0%

No self-harm or suicidal thoughts:4476573778.0%

Male

2669302588.2%

Female

1791269266.5%

Gender Unspecified

162080.0%

Source: Deliberate self-harm in adolescents: self-report survey in schools in England, Keith Hawton, Karen Rodham, Emma Evans & Rosamund Weatheral, British Medical Journal, 2002

12.6% of incidents of self-harm resulted in a hospital admission.

Methods used:

Method Occurrences%

Cutting 25764.6%

Overdose/Poisoning <12230.7%

Other 194.8%

Total 379100.0%

Source: Deliberate self-harm in adolescents: self-report survey in schools in England, Keith Hawton, Karen Rodham, Emma Evans & Rosamund Weatheral, British Medical Journal, 2002

A Cry for Help?

One of the more common responses to an episode of self-harm is to view it as a cry for help. While this is a more compassionate interpretation than simple condemnation of the person, this interpretation leaves a problem. Most people who want help are also willing to help themselves. However, people who are engaging in self-harm are clearly not engaging in self-help.

A Cry for Attention?

Another common misconception about self-harm is that it is a cry for attention. The problem with this interpretation is the large number of people who engage in secretive self-harm, such as cutting in areas generally kept clothed.

Why do people Self Harm?

When asked why they do it, there are two common reasons given:

  1. Some say they feel a sense of numbness or emptiness and do it because it feels good to feel “something.”
  2. Some say they are under acute stress and do it as a diversion.

How it affects loved ones

When a Personality-Disordered individual engages in self-harm or suicidal behavior, most Nons react with a mixture of guilt, alarm, betrayal and/or anger. They will often look for reasons for the behavior, based on their own logic, and may blame themselves, or their own inability to solve the Personality-Disordered individual’s discontent.

Some Nons may also feel a sense of relief as the self-harm incident gives them legitimate “cover” to seek external help and substitute a more assertive action plan for the unresolved conflict, and also it gives them evidence of major mental health issues which may be more “believable” to friends and family.

What NOT to do

  • Don’t ignore it. Most self-harm incidents are signs of a serious underlying problem and will be repeated.
  • Don’t try to deal with this yourself. Self-injury is a serious problem and needs the engagement of expert trained professionals.
  • Don’t blame yourself. Self-injury is just that - self-inflicted. It is not abuse by another.

What TO do

  • If someone you know threatens self-harm or commits an act of serious self-harm, call 911 immediately. Police and ambulance officers have the skills and resources to deal with the situation and will see that the person is given an immediate medical and mental health assessment, which is the first step towards possible therapeutic intervention.
  • Protect any innocent children or bystanders.
  • Be supportive but firm.
  • See our Emergency Page for more information.

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